RT Journal Article
SR Electronic
T1 The value of extended short-term medical training placements in smaller rural and remote locations on future work location: a cohort study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e068704
DO 10.1136/bmjopen-2022-068704
VO 13
IS 1
A1 McGrail, Matthew R
A1 Nasir, Bushra F
A1 Chater, Alan Bruce
A1 Sangelaji, Bahram
A1 Kondalsamy-Chennakesavan, Srinivas
YR 2023
UL http://bmjopen.bmj.com/content/13/1/e068704.abstract
AB Objectives To investigate the effects of extended short-term medical training placements in small rural and remote communities on postgraduate work location.Design and setting Cohort study of medical graduates of The University of Queensland, Australia.Participants Graduating medical students from 2012 to 2021 who undertook a minimum of 6 weeks training in a small rural or remote location. Some participants additionally undertook either or both an extended short-term (12-week) placement in a small rural or remote location and a long-term (1 or 2 years) placement in a large regional centre.Primary outcome measure Work location was collected from the Australian Health Practitioner Regulation Agency in 2022, classified as either rural, regional or metropolitan and measured in association with rural placement type(s).Results From 2806 eligible graduates, those participating in extended small rural placements (n=106, 3.8%) were associated with practising rurally or regionally postgraduation (42.5% vs 19.9%; OR: 2.2, 95% CI: 1.1 to 4.6), for both those of rural origin (50% vs 30%; OR: 4.9, 95% CI: 2.6 to 9.2) or metropolitan origin (36% vs 17%; OR: 2.8, 95% CI: 1.7 to 4.8). Those undertaking both an extended small rural placement and 2 years regional training were most likely to be practising in a rural or regional location (61% vs 16%; OR: 8.6, 95% CI: 4.5 to 16.3). Extended small rural placements were associated with practising in smaller rural or remote locations in later years (15% vs 6%, OR: 2.7, 95% CI: 1.3 to 5.3).Conclusion This work location outcome evidence supports investment in rural medical training that is both located in smaller rural and remote settings and enables extended exposure with rural generalists. The evaluated 12-week programme positively related to rural workforce outcomes when applied alone. Outcomes greatly strengthened when the 12-week programme was combined with a 2-year regional centre training programme, compared with either alone. These effects were independent of rural origin.Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. The University of Queensland (UQ) Human Ethics Committee imposes restrictions on the data. Anonymised data are available to researchers who meet the conditions of the ethics approval and research governance policy that applies to this study via UQ eSpace. Requests for the data may be sent to the Director of Research, Rural Clinical School, UQ (rcsrc@uq.edu. au)